IntroductionThe Apixaban for the Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation ARISTOTLE, Randomized Evaluation of Long-term Anticoagulation Therapy RE-LY, and Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation ROCKET-AF trials demonstrated that the oral anticoagulants OACs, apixaban, dabigatran, and rivaroxaban, respectively, are efficacious for stroke prevention among nonvalvular atrial fibrillation NVAF patients. Based on clinical trial results this study evaluated medical costs of clinical events associated with use of individual OACs relative to those of warfarin in NVAF patients with moderate and high stroke risk.

MethodsRates for primary and secondary efficacy and safety outcomes i.e., clinical events among NVAF patients with CHADS2 = 2 and ≥3 were determined from the three OAC trials. One-year incremental costs among patients with clinical events from a US payer perspective were obtained from the literature and inflation adjusted to 2010 costs. Medical costs for clinical events associated with each OAC vs. warfarin were estimated and compared.